Monitor’s approach to leadership, culture and governance assessment

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Under the Health and Social Care Act 2012, Monitor was established as the 'sector regulator' for health services in England and given a new primary duty: 'to protect and promote the interests of people who use health care services by promoting provision of health care services which is economic, efficient and effective, and maintains or improves the quality of the services.'

Monitor's approach to making sure provider organisations are well led has so far focused on the role of the board and the organisation's governance arrangements, and more recently on quality governance looking forward and recognising the scale of the challenges facing providers. Monitor are paying more attention to the capability of provider organisations and their leaders to sustain performance in a rapidly changing world, in particular to focus on the capabilities that drive long term performance; strategic and business planning; organisational development; operational performance improvement; and individual leadership.

Monitor, the Care Quality Commission and the NHS Trust Development Authority are also working together to provide NHS providers with a single view of what good leadership looks like by developing an aligned framework for making judgements about how well led NHS providers are. This framework will ensure a consistent view which will form the basis of regulatory judgements. A joined-up approach will also remove unnecessary duplication and burden on NHS providers.

In this session, Carolyn May, Monitor's Senior Development Advisor, discussed their approach to leadership, culture and governance assessment for foundation trusts including the use of the “Well-led framework for Governance Reviews” and the Strategy Development Toolkit.


Carolyn May

Senior Development Adviser, Monitor

Carolyn is a Senior Development Advisor at Monitor. She has been at Monitor since April 2010 and has run development initiatives particularly for Chairs, CEOs, Non-Executive Directors and foundation trust governors as well as a number of research projects into good practice in aspects of foundation trust governance. She is particularly keen to support senior leaders of organisations who may otherwise feel quite isolated, and to support genuine medical leadership with a true focus on outcomes for patients. Prior to joining Monitor, Carolyn was a Director of two FSA regulated trading businesses, which she helped to build from start-up. Prior to that she spent four years in Singapore working in private wealth management having originally qualified as a Chartered Accountant with Pricewaterhouse Coopers before acting as a management consultant for IBM. Carolyn was diagnosed as a coeliac in 2005 after years of related health issues and is therefore particularly interested in strong diagnosis at a primary care level as well as ensuring patient care is integrated across primary and secondary care, improving patient experience and making better use of resources.